Possible hypothalamic impotencemale counterpart to hypothalamic amenorrhea?

Guay, André T.; Bansal, Shikha; Hodge, Mary Beth

doi:10.1016/0090-4295(91)80143-u

Cited by 27 publications

(23 citation statements)

References 14 publications

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“…[18][19][20][21][22] Hypogonadotropic hypogonadism is much more common than primary testicular failure. 11,15,23,24 In our clinic, which has a bias toward endocrine referrals, 36% of approximately 1000 consultations for ED monitored over a 2-y period had hypogonadism. 25 Of these, 6% had primary hypogonadism while 30% had secondary hypogonadism.…”

Section: Introductionmentioning

confidence: 93%

“…[8][9][10] Chronic illnesses also may cause hypogonadism, 3,[11][12][13][14] which may be complicated by concomitant use of medications. 15 Psychological as well as physical stressors commonly lead to secondary or hypogonadotropic hypogonadism 16 and hypothalamic suppression of gonadotropin-releasing hormone is thought to be the cause. 11,15,17 Hypogonadism has long been associated with sexual dysfunction.…”

Section: Introductionmentioning

confidence: 99%

“…15 Psychological as well as physical stressors commonly lead to secondary or hypogonadotropic hypogonadism 16 and hypothalamic suppression of gonadotropin-releasing hormone is thought to be the cause. 11,15,17 Hypogonadism has long been associated with sexual dysfunction. [18][19][20][21][22] Hypogonadotropic hypogonadism is much more common than primary testicular failure.…”

Section: Introductionmentioning

confidence: 99%

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Clomiphene increases free testosterone levels in men with both secondary hypogonadism and erectile dysfunction: who does and does not benefit?

Guay¹,

Jacobson

Perez³

et al. 2003

Int J Impot Res

118

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Secondary hypogonadism is more common than primary gonadal failure and is seen in chronic and acute illnesses. Although testosterone has a role in erections, its importance in erectile dysfunction (ED) has been controversial. Hypogonadism produced by functional suppression of pituitary gonadotropins has been shown to correct with clomiphene citrate, but with a modest effect on sexual function. We wondered if longer treatment would produce improved results. A total of 178 men with secondary hypogonadism and ED received clomiphene citrate for 4 months. Sexual function improved in 75%, with no change in 25%, while significant increases in luteinizing hormone (Po0.001) and free testosterone (Po0.001) occurred in all patients. Multivariable analysis showed that responses decreased significantly with aging (Po0.05). Decreased responses also occurred in men with diabetes, hypertension, coronary artery disease, and multiple medication use. Since these conditions are more prevalent with aging, chronic disease may be a more important determinant of sexual dysfunction. Men with anxiety-related disorders responded better to normalization of testosterone. Assessment of androgen status should be accomplished in all men with ED. For those with lower than normal age-matched levels of testosterone treatment directed at normalizing testosterone with clomiphene citrate is a viable alternative to giving androgen supplements.

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Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clomiphene increases free testosterone levels in men with both secondary hypogonadism and erectile dysfunction: who does and does not benefit?

Guay¹,

Jacobson

Perez³

et al. 2003

Int J Impot Res

118

View full text Add to dashboard Cite

show abstract

“…Têm sido descritos casos de homens com DS, nos quais coexistem níveis subnormais de testosterona e normais de gonadotropinas e Prl, não sendo encontradas anomalias anatômicas hipotálamo-hipofisárias que justifiquem tal fato (3). O quadro laboratorial destes pacientes configura um hipogonadismo secundário e, mais precisamente, um hipogonadismo hipogonadotrópico idiopático pós-puberal (3,4).…”

Section: Discussionunclassified

“…O quadro laboratorial destes pacientes configura um hipogonadismo secundário e, mais precisamente, um hipogonadismo hipogonadotrópico idiopático pós-puberal (3,4). A resposta ao teste de LHRH é normal mas, inesperadamente, mais lenta do que seria de se esperar em presença de níveis androgênicos subnormais.…”

Section: Discussionunclassified

Insuficiência androgênica de origem hipotálamo-hipofisária em dois homens com disfunção sexual

2000

Arq Bras Endocrinol Metab

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There is a group of middle-aged men with sexual dysfunction that presents reduced serum testosterone levels and normal to low levels of prolactin and gonadotropins, but without any dermonstrable hypothalamicpituitary anatomic abnormality. This condition is considered a form of idiopathic hypogonadotropic hypogonadism, probably of hypothalamic origin. We present and discuss two patients with similar features in whom sexual dysfunction preceded actual hypoandrogenism. We conclude that in these two patients hypoandrogenism was the consequence of a psychoneuroendocrine disturbance due to the sexual dysfunction. 1,2). No entanto, têm sido descritos casos de pacientes não idosos com DS e hipoandrogenismo secundário na ausên-cia de lesão orgânica hipotálamo-hipofisária, nos quais a origem destes achados permanece obscura. Estamos apresentando os casos de dois destes pacientes, e discutindo as possíveis causas do hipoandrogenismo e sua relação com a DS. Caso lPaciente de 46 anos, casado e com um filho de 5 anos, visto em abril de 1997 com libido normal e queixas de disfunção erétil e ejaculação precoce. Sendo professor universitário em fase de doutoramento, encontrava-se sob stress intenso (sic), que era agravado pela própria DS. Não fumava, mas referia ingestão diária de bebidas alcoólicas. Seu IMC era 21 kg/m 2 . Os exames clínico e da genitália resultaram normais. A capacidade erétil era normal, comprovada por um teste de injeção intracavernosa de prostaglandina.

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Androgen Deficiency

Cunningham¹,

Hirshkowitz²

1997

Male Infertility and Sexual Dysfunction

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Possible hypothalamic impotencemale counterpart to hypothalamic amenorrhea?

Cited by 27 publications

References 14 publications

Clomiphene increases free testosterone levels in men with both secondary hypogonadism and erectile dysfunction: who does and does not benefit?

Clomiphene increases free testosterone levels in men with both secondary hypogonadism and erectile dysfunction: who does and does not benefit?

Insuficiência androgênica de origem hipotálamo-hipofisária em dois homens com disfunção sexual

Androgen Deficiency

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